Specialized Treatment for Under-Eyelid Bags in Cincinnati
- Causes of under eye bags and puffy eyelids
- How aging, anatomy, and volume loss affect appearance
- Surgical and non-surgical treatment options for eyelid bags
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What Are Eyelid Bags/Under Eye Bags?
Eyelid bags are a common source of frustration and anxiety among patients. They can make us look tired, sad, and older. The cause of lower eyelid bags is multi-factorial and includes:
- Genetics
- Lifestyle (e.g. poor sleep, smoking, alcohol use, stress)
- Time/age
What Causes Puffy Under Eye Bags
They are the result of fat pads in the lower eyelids that normally surround the globe i.e., "eyeball" stretching forward against a "wall," called the septum, holding it back. The "doctor term" for this process is pseudo-herniation of inferior orbital fat.
There are other changes that can occur in the lower eyelids at the same time. They include:
- Loosening of the muscle, called the orbicularis oculi, around the eyes
- Loosening and redundancy of the skin of the lower eyelid
Conditions That Mimic Under Eye Bags
Lower blepharoplasty surgery can treat age-related changes to fat, muscle, and skin in many individuals. However, there are some changes to the lower eyelid region that lower eyelid surgery does not treat:
- Hyperpigmentation i.e. "dark circles" under the eyes – I tell patients that, if I had a consistently effective solution to dark circles under the eyes, "I would be on an island somewhere." This is because there is currently no available treatment I am aware of that consistently and effectively treats this.
- Boggy, watery edema in the cheek near the junction with the lower eyelid, called festoons or malar edema – malar edema does not involve the lower eyelid but patients often believe it does. Electrocautery and energy-based devices (e.g. radiofrequency, ultrasound) have been tried, though these approaches are generally ineffective. In contrast, surgical removal is effective but can leave unsightly scars on the cheeks.
- Hollowing at the tear troughs – this is present as an isolated feature more commonly in younger individuals who have not yet developed lower eyelid bags. Tear trough hollows can be treated by using products that add volume to the face, such as hyaluronic acid fillers and/or fat grafting.
How Volume Loss Changes the Appearance of Eyelid Bags
The three features above are not undereye bags. Therefore, they cannot be treated with blepharoplasty (eyelid) surgery. However, there is a condition that often exists with lower eyelid bags that, like tear trough hollowing, can be treated by adding volume. Volume is often lost a little lower in the face, near the junction between the cheek and the lower eyelid. A youthful face has a relatively-flat-to-softly-rounded lower eyelid that quickly transitions to a projection of volume in the upper cheek. This is the start of the ogee curve. The ogee curve is an S-shaped curve that transitions from the convex projection of the cheeks to the concavity at approximately the buccal cheek, which is located lower in the face. Two (2) changes to the ogee curve can develop with age:
- The fat compartments in the cheeks fall forward due to gradual weakening of the soft tissue attachments that surround them. As a result, volume falls away from the lower eyelid.
- Fat in these compartments is lost, leading to reduced projection of the cheeks.
Why Choose Dr. Harmon
The desire for youthfulness is understandable. There is no area more important than the face. After all, the face cannot be hidden. It is how we present ourselves to the world. Dr. Harmon works with a refined eye and trained hands to develop a personalized treatment plan with you, utilizing advanced techniques in surgical and non-surgical care of the face, nose, eyes, neck and hair.
Fellowship trained facial plastic surgeons have a unique specialized skill set in performing surgical and non-surgical procedures on the face, nose, eyes, neck and hair. The pathway to becoming a facial plastic surgeon begins with five years of rigorous training in head and neck surgery. This training is focused on all aspects of surgery for the head and neck, in addition to aesthetic and reconstructive procedures.
A small pool of top performing graduates from head and neck surgery programs are then selected to complete sub-specialty training as a fellow in facial plastic and reconstructive surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS).
Dr. Harmon completed his fellowship in facial plastic surgery through the AAFPRS with the world-renowned facial plastic surgeon Dr. Andrew Jacono on Park Avenue in New York City. Dr. Jacono is world renowned for developing the extended deep plane facelift technique. Dr. Harmon is one of the few surgeons in the world, and the only surgeon in the Cincinnati area, fellowship trained in this technique by Dr. Jacono.
QUAD A ACCREDITED SURGERY SUITE
Harmon Facial Plastic Surgery is proud to have a Quad A accredited operating room and facility in our office. Our single-physician, single-specialty facility meets or exceeds the strict guidelines and high standards set forth by Quad A, demonstrating our strong commitment to patient safety and excellence in surgical care. We utilize the services of board-certified anesthesiology physicians only as well as our own personal clinical support staff to ensure the most comfortable, safest experience for our clients.
Treatment Options for Bags Under Eyes
The smooth transition of volume between parts of the face is lost when lower eyelid bags combine with volume loss and drooping/ptosis of the cheeks. The result is a coarsening of the face, which is a sign of aging. Therefore, a comprehensive approach to treat facial aging in this area would seek to address as many age-related changes as possible. While not a replacement for lower eyelid surgery, these procedures can enhance the appearance of this area, restoring more youthful proportions:
- Deep plane facelift surgery can provide a lift of the cheeks, also known as midface, closer to the lower eyelids.
- Fat grafting to the cheeks/midface can restore some of the lost volume.
In addition, a patient's eye position can affect the relative appearance of the lower eyelid bags. For example, individuals with eyes that project out past their cheeks – called a negative vector by physicians – tend to have much more dramatic-appearing lower eyelid bags relative to someone whose eyes sit deeper. This difference does not usually change surgery or the surgical approach except for subtle nuances that need to be factored into patients with more projected eyes.
Consult Dr. Harmon for Eyebags Treatment in Cincinnati
It is clear from the above discussion that much of facial plastic surgery involves the restoration of youthful volume in the face. This includes the lower eyelids. Patients throughout Cincinnati consult with Dr. Harmon for bags under the eyes. He can evaluate the volume and anatomical changes for a treatment plan specific to your facial structure. Contact us today.
Written by Dr. Harmon
Discover the expertise and compassionate care of Dr. Jeff Harmon, a fellowship-trained facial plastic surgeon deeply rooted in the Cincinnati community. A former collegiate athlete and Cornell University graduate, Dr. Harmon brings discipline, precision, and a global perspective to his surgical practice—refined through elite fellowship training in New York City.
Located in Hyde Park, Harmon Facial Plastic Surgery proudly serves patients throughout the Cincinnati area offering personalized facial aesthetics with world-class skill and a hometown heart.